Objective To investigate the correlation between the rate of pathological complete response (pCR) and prognostic nutritional index (PNI) in gastric cancer patients who underwent neoadjuvant chemotherapy (NAC). Methods A total of 278 advanced gastric cancer patients who underwent NAC and R0 gastrectomy with D2 lymphadenectomy between January 2012 and March 2017 at the Affiliated Tumor Hospital of Zhengzhou University were analyzed retrospectively. Propensity score matching (PSM) was conducted to reduce the confounding bias between the groups (PNI＜45, 157 patients; PNI≥45, 121 patients). Multivariate analysis was used to determine the independent risk factors of the pCR rate in gastric cancer patients who underwent NAC. Results PNI (OR:3.026;95％ CI:1.261, 7.260;P = 0.013), differentiation (OR:0.470;95％ CI:0.270, 0.819;P = 0.008), and tumor location (OR:0.341;95％ CI:0.164, 0.708;P = 0.004) were the independent risk factors associated with the pCR rate of the gastric cancer patients who underwent NAC. After PSM, PNI (OR:2.728;95％ CI:1.130, 6.587;P = 0.026) was the independent risk factor associated with the rate of pCR after NAC. Conclusion Gastric cancer patients who underwent NAC with low PNI are less likely to get pCR than those with normal PNI.%目的 探讨预后营养指数 (PNI) 与胃癌新辅助化疗 (NAC) 后病理完全缓解 (pCR) 的相关性.方法 回顾性分析郑州大学附属肿瘤医院2012年1月至2017年3月行NAC且接受胃癌根治术的278例进展期胃癌患者的临床资料, 其中低PNI组157例, PNI正常组121例.利用倾向评分匹配法 (PSM) 消除2组间混杂因素, 获得基线资料平衡的2组患者, 利用多因素分析匹配前后影响获得pCR的危险因素.结果 匹配前, PNI (OR:3.026;95％CI:1.261, 7.260;P=0.013) 、分化类型 (OR:0.470;95％CI:0.270, 0.819;P=0.008) 、肿瘤部位 (OR:0.341;95％CI:0.164, 0.708;P=0.004) 是影响NAC后获得p CR的独立危险因素.1:1匹配后, PNI正常组和低PNI组患者一般临床资料均衡 (P＞ 0.05) .多因素分析显示, 低PNI (OR, 2.728;95％CI:1.130, 6.587;P=0.026) 是影响p CR率的独立危险因素.结论 低PNI的胃癌患者行NAC, 获得pCR可能性比PNI正常患者低.
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